{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T08:46:40Z","timestamp":1767084400636},"reference-count":15,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground:<\/jats:title>\nSimultaneous cerebral and myocardial infarction is called cardio-cerebral infarction (CCI). It is a rare condition, and its management strategy has yet to be determined. We report a case of cardiac tamponade during the treatment of CCI associated with atrial fibrillation.<\/jats:p>\n<\/jats:sec>\n\nCase Description:<\/jats:title>\nA 72-year-old man presented with loss of consciousness after chest discomfort. He had taken rivaroxaban for paroxysmal atrial fibrillation. Twelve-lead electrocardiography showed ST elevation at II, III, and aVF. His National Institutes of Health Stroke Scale was 29. We diagnosed him with synchronous cardioembolic stroke and acute myocardial infarction due to atrial fibrillation. The coronary angiography revealed distal occlusion in the posterior descending branch of the right coronary artery, and overall myocardial perfusion seemed sufficient. The diffusion-weighted image showed hyperintense lesions at the cerebellum, and magnetic resonance angiography did not reveal the flow of the basilar artery. The patient\u2019s NIH score improved immediately, so we did not perform intravenous tissue plasminogen activator (IV-tPA) administration nor endovascular treatment. Heparin administration was started. After 38 h from the onset, he suffered from hydrocephalus, and cerebral ventricular drainage was performed. Subsequently, circulatory dynamics worsened, and he was diagnosed with cardiac tamponade. Emergency pericardiotomy was performed, and he has been taking intensive care.<\/jats:p>\n<\/jats:sec>\n\nConclusion:<\/jats:title>\nSome cases with CCI treated with IV-tPA and endovascular intervention were reported, but the treatment strategy should be still discussed multidisciplinary. Especially, the administration of antithrombotic drugs for CCI should be carefully performed because fatal hemorrhage such as cardiac tamponade can occur.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_504_2019","type":"journal-article","created":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T01:20:15Z","timestamp":1575595215000},"page":"241","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["A case of cardiac tamponade during the treatment of simultaneous cardio-cerebral infarction associated with atrial fibrillation \u2013 Case report"],"prefix":"10.25259","volume":"10","author":[{"given":"Masahito","family":"Katsuki","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigemi","family":"Katsuki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2019,12,6]]},"reference":[{"key":"10.25259\/SNI_504_2019\/ref-1","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1186\/s12883-019-1388-1","article-title":"Simultaneous cardio-cerebral embolization associated with atrial fibrillation: A case report","volume":"19","author":"Abe","year":"2019","journal-title":"BMC Neurol"},{"key":"10.25259\/SNI_504_2019\/ref-2","first-page":"135","article-title":"Tako-tsubo syndrome as a consequence and cause of stroke","volume":"29","author":"Bersano","year":"2014","journal-title":"Funct Neurol"},{"key":"10.25259\/SNI_504_2019\/ref-3","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1093\/ageing\/6.1.29","article-title":"Myocardial infarction coincident with cerebrovascular accidents in the elderly","volume":"6","author":"Chin","year":"1977","journal-title":"Age Ageing"},{"key":"10.25259\/SNI_504_2019\/ref-4","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.ijcard.2008.06.085","article-title":"Acute myocardial infarction and transient ischemic attack in a patient with lone atrial fibrillation and normal coronary arteries","volume":"139","author":"Chlapoutakis","year":"2010","journal-title":"Int J Cardiol"},{"key":"10.25259\/SNI_504_2019\/ref-5","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1016\/j.amjcard.2013.12.015","article-title":"Incidence and predictors of early left ventricular thrombus after ST-elevation myocardial infarction in the contemporary era of primary percutaneous coronary intervention","volume":"113","author":"Gianstefani","year":"2014","journal-title":"Am J Cardiol"},{"key":"10.25259\/SNI_504_2019\/ref-6","doi-asserted-by":"crossref","first-page":"1157.e1","DOI":"10.1016\/j.ajem.2014.02.047","article-title":"Reperfusion strategy for simultaneous ST-segment elevation myocardial infarction and acute ischemic stroke within a time window","volume":"32","author":"Gonz\u00e1lez-Pacheco","year":"2014","journal-title":"Am J Emerg Med"},{"key":"10.25259\/SNI_504_2019\/ref-7","doi-asserted-by":"crossref","first-page":"795.e1","DOI":"10.1016\/j.ajem.2018.12.060","article-title":"Optimal treatment modality for coexisting acute myocardial infarction and ischemic stroke","volume":"37","author":"Gungoren","year":"2019","journal-title":"Am J Emerg Med"},{"key":"10.25259\/SNI_504_2019\/ref-8","doi-asserted-by":"crossref","first-page":"664","DOI":"10.3389\/fneur.2017.00664","article-title":"Hyperacute simultaneous cardiocerebral infarction: Rescuing the brain or the heart first?","volume":"8","author":"Kijpaisalratana","year":"2017","journal-title":"Front Neurol"},{"key":"10.25259\/SNI_504_2019\/ref-9","doi-asserted-by":"crossref","first-page":"84","DOI":"10.5853\/jos.2015.17.1.84","article-title":"Acute stroke with concomitant acute myocardial infarction: Will you thrombolyse?","volume":"17","author":"Maciel","year":"2015","journal-title":"J Stroke"},{"key":"10.25259\/SNI_504_2019\/ref-10","doi-asserted-by":"crossref","first-page":"218","DOI":"10.5692\/clinicalneurol.54.218","article-title":"Case of cardiac tamponade during the treatment of acute cerebral infarction","volume":"54","author":"Nagasawa","year":"2014","journal-title":"Rinsho Shinkeigaku"},{"key":"10.25259\/SNI_504_2019\/ref-11","doi-asserted-by":"crossref","first-page":"776","DOI":"10.12659\/AJCR.916114","article-title":"Simultaneous acute anterior ST-elevation myocardial infarction and acute ischemic stroke of left middle cerebral artery: A case report","volume":"20","author":"Obaid","year":"2019","journal-title":"Am J Case Rep"},{"key":"10.25259\/SNI_504_2019\/ref-12","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/1755-7682-3-25","article-title":"Concomitant acute right ventricular infarction and ischemic cerebrovascular stroke; 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